Dossier · Medicaid & Insurance · New York
New York Medicaid cuts the fee-for-service rate for ABA technician services
Latest development · Verified Oct 26, 2026
New York fee schedule confirms 97153 at $9.63 per unit and lists the other ABA codes
What changed
The August 2026 New York Medicaid Update states that, as authorized by the New York State Enacted Budget for Fiscal Year 2026 to 2027, New York State Medicaid fee for service will decrease the fee paid for Applied Behavioral Analysis services provided by unlicensed individuals and technicians represented by CPT code "97153." Effective October 1, 2026, the reimbursement for CPT code "97153" is reduced to $9.63 per unit. The notice directs providers to the eMedNY Applied Behavior Analysts web page for the current fee schedule and policy guidelines.
Who it affects. This notice reaches fee for service billing only. It does not address Medicaid managed care, so a practice billing through a managed care plan should confirm the applicable rate directly with that plan rather than assume the fee-for-service figure carries over. Any New York ABA practice that bills CPT 97153 for services an unlicensed technician delivers under BCBA or licensed behavior analyst supervision is affected, regardless of practice size. See the New York Medicaid and insurance page for the state's broader coverage picture.
What to do now
The eMedNY fee schedule effective October 1, 2026 lists $9.63 per unit for CPT 97153, matching this notice. Separately confirm the applicable rate with each Medicaid managed care plan a practice contracts with, since this notice states only the fee-for-service change. This is not legal, tax, or billing advice; confirm every figure with eMedNY or the relevant managed care plan before relying on it. See the Medicaid and insurance hub for how Medicaid enrollment and billing work across states, and the guides hub for broader practice operations guidance.
Timeline, newest first
2026-10-26Live
New York fee schedule confirms 97153 at $9.63 per unit and lists the other ABA codes
The eMedNY ABA fee schedule, titled NYS Medicaid Applied Behavior Analysis Services Fee Schedule and carrying an effective date of October 1, 2026, lists CPT 97153, adaptive behavior treatment by protocol administered by a technician for one patient, at $9.63 per 15 minute unit. That confirms the figure in the August 2026 Medicaid Update, which our October 23 entry could not check against the schedule.
The same schedule lists $19.26 per unit for 97151, 97152, 97155 and 97156, and $3.31 per unit per member for the group codes 97154, 97157 and 97158. The schedule has no modifier or unit column, and each description states its unit.
The August 2025 Medicaid Update set the earlier steps for 97153 at $16.85 per unit from October 1, 2025 and $14.45 per unit from April 1, 2026, and set a minimum supervision standard of five percent of technician hours each month, with two face to face contacts, which the Update says also applies to managed care providers. Neither Update states a percentage. Measured against $19.26, the steps are 87.5%, 75% and 50%; that is our arithmetic. The August 2026 Update addresses fee for service only, and we have not seen how managed care plans price 97153.
Source: eMedNY, Applied Behavior Analysis fee schedule (effective October 1, 2026)
2026-10-23
New York Medicaid sets CPT 97153 for unlicensed technicians at $9.63 per unit from October 1, 2026
The August 2026 New York State Medicaid Update (Volume 42, Number 9) announces a reimbursement change for unlicensed individuals providing applied behavior analysis services under fee-for-service Medicaid. For CPT code 97153, reimbursement is reduced to $9.63 per unit, effective October 1, 2026.
The update says the change is authorized by the enacted budget for State Fiscal Year 2026-2027, and directs providers to the eMedNY Applied Behavior Analysts web page for the current fee schedule and policy guidelines. It does not state the prior rate or the size of the reduction. This entry rests on the Medicaid Update; the posted eMedNY fee schedule was not checked.
Source: New York State Department of Health, Medicaid Update, August 2026, Volume 42, Number 9
If this rate change touches how you bill, the payer and Medicaid rules advisory maps it to your operation.
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ABAWiser provides research, analysis, and compliance advisory services. We are not a law firm, we do not provide legal advice, and no engagement creates an attorney client relationship. Dossiers track developments as they occur and may be incomplete or updated as a story evolves. Confirm any statutory or regulatory point against the primary source before acting on it.